Rhythm maintaining device for artificial respiration



July 11, 1933. KNAPKE 1,918,041

RHYTHM MAINTAINING DEVICE FOR ARTIFICIAL RESPIRATION Filed Jan. 29, 1932INVENTOR BY B W AT ORNEY Patented July 11, 1933 FRED KNAPKE, OF MIDDLEVILLAGE, LONG ISLAND, NEW YORK RHYTHM MAINTAINING DEVICE FOR ARTIFICIALRESPIRATION App1ication filed January 539, 1932. Serial No. 583,681.

This invention relates to the saving of human life by the socalled pronemethod of artificial respiration.

It is known that to be successful, the respiration must be maintained atone definite rate, to wit, l5 respirations per minute, for adults andanother definite rate, namely 30 respirations per minute, for children;it is known furthermore, that the action, at the rate required should becontinuous and in the same continuous rhythm. Under present methods, theoperator endeavors to maintain the proper timing and continuity ofrhythm by counting. The ability to accomplish this result naturallyvaries with different operators and as the operation is tediousrequiring a change of operators approximately every 15 minutes, it is afact that variations in rhythm are unconsciously or acci- 29 dentlyintroduced, often prejudicial to the recovery of the victim- The objectsof this invention are to obviate, so far as possible, theseirregularities and variations in the rhythm and to provide 555 means ofa simple practical nature for enabling operators in the prone method ofresuscitation to maintain continuously through prolonged periods therhythmic respiration required for the patient under treatment.

These objects and others of like desirable character are accomplished inthe present in vention by the novel features and combinationshereinafter disclosed.

The drawing accompanying and forming part of the specificationillustrates one of the practical commercial embodiments of the inventionbut it is to be understood that the actual structure may be modified andchanged as regards this disclosure all within the true intent and broadscope of the claims.

Fig. 1 is a perspective view illustrating a form of the invention asincorporated with the inhalator and as in use in the prone method ofresuscitation.

Fig. 2 is a face view ofthe rhythm instrument as removed from the caseof the inhalator.

p Fig. 3 is a vertical sectional view of the instrument as onsubstantially the plane of line 3-3 of Fig. 2.

Fig. 1 is a broken sectional view showing in particular the control forchanging the rhythm from 15 to 80 respirations per minute or vice versa.

The construction herein shown comprises a suitable motor indicated at 5in Fig. 3 and which may be a clock motor, electric motor or the like, itbeing requisite that the same be capable of running continuously anduniformly over a period of four hours or longer. A spring actuated clockmovement is shown, adapted to be wound by a suitablekey 6, pro jectingfrom the side of the instrument case 7 in positionto be readily andquickly actuated.

The motor drives a timing train, shown as two gears 8, 9, the first ofhalf the number of teeth of the other, both loosely confined on themotor drive shaft 10 and adapted either to be coupled in driven relationon the shaft by a sliding jaw clutch collar 11, keyed or splined, as byworking on a squared portion 12 of the shaft and having jaw teeth 13, 11, at its opposite ends for engagement respectively with j aw teeth 15,16, on the opposing hubs of the gears 8, 9, which mesh respectively withthe gears 17, 18, on shaft In the manner described, the shaft 19 isdriven at a rate corresponding to either 15 respirations per minute or30 respirations per minute, depending upon which of the gears 8, 9, isclutched to the motor shaft.

For indicating purposes, the shaft 19 is shown as extended out throughthe front of the case and as carrying an indicator or pointer 20, whichby cooperation with a suit able marker 21 will afford an indication ofthe rhythm necessary to be maintained for either the adult or the infantrate of respiration.

Control of the clutch and hence changeover from one rate of respirationto the other is effected in the illustration by a turn button 22,journalled in the front of the case carrying a pointer 23, to registerwith either the 15 or the SO indications 24:, 25, on the front of thecase and coupled by screw connection 26, with a sleeve 27 pivoted to oneend of the lever 28, pivotally mounted at 29 and having a shipping fork30 at its opposite end entered in the groove 31 of the clutch collar.The screw coupling is pitched so that a quick turn of the control buttonWill be efi'ected to change the mechanism from one rhythm to the other.Stop pins 32 are shown provided for the pointer 23, requ1ri ng theturning of the control button 111 the proper direction for effecting thechange from one rate to the other and avoiding any question or loss oftime through unfamiliarity with the apparatus.

To make the rhythmic action more real and more easily followed by theoperators, there is provided in the illustration, a complcte picture ofthe proper rhythmic action by a miniature representation on the front ofthe case of both the proper position of the victim and the proper actionof the operator. This consists in the disclosure of the representation33 on the front of the case of a victim in the proper prone position andan operator 34 exercising the proper prone method on such victim. Thefigure of the operator is for such purpose shown pivoted at the knee at35, so that it may rock up and down over the back of the other figureand as having the arm 36 in a straight condition pivoted to the body ofthe figure at the shoulder at 37 and the hand portion as working overthe small of the back by a pin 38, sliding in an inclined guide slot 39in the wall of the case. The knee pivot 35 is shown provided by arocking shaft 40 journalled in the case and rigidly attached at itsouter end to the knee portion of the figure and said shaft is shown asoperated by means of a lever arm 41 on the shaft connected by pivotedlink 42 to a crank 43 on the time shaft 19.

The construction described provides a visual indication of both theproper positions and of the necessary rhythmic motions, for either rateof respiration. The instrument is preferably supported, as by mountingit in the cover 44 of the inhalator case 45, so that it will be inproper position for natural and easy observation of the same by theoperator. The inhalator case is usually located at the head of thevictim, directly in front of the operator, which position makes the casea convenient and practicable support for properly positioning the rhythmmaintaining instrument. For the purpose, the case of the instrument isshown as having a back flange 46 perforated for screws to fasten thedevice in the cover of the inhalator case.

In many cases the operator, called upon to start resuscitation at oncemay have to work in a dark place or darkness may come on in the courseof the operation, without immediate light available. To meet suchsituations, an illuminated or audible signal may be given as by means ofan electric circuit governed by the timing train and'ineluding a lalnp,a buzzer or the like. In the illustration, such signal is shown as aminiature lamp 47 in back of a window 48 in the front of the casedesirably positioned to illuminate the rhythm indicator or indicators,having circuit connections 49 connected with a battery or otherelectrical source and having normally separated switch contacts 50,designed to be connected by a switch or contact element 51 on the timedrocking shaft 40, Fig. 3. If desired, the buzzer or audible signal maybe included in this same circuit as indicated at 52, or the audiblesignal alone be used. The light may be preferred however, as giving botha visible rhythmic signal and at the same time a rhythmic illuminationof the indicator or indicators.

Control of the starting and stopping of the apparatus is effected in thedisclosure by a push button or plunger 53, set in the front of the caseand carrying at its inner end a spring brake 54, for engagement with apart of the clock movement, said control plunger having suitable springdetent mechanism 56 by which it is held in either the running or stopposition.

In addition to its use in the field, the invention is of special valuein the schooling of operators for rescue squads, especially in that itdemonstrates to the student in readily assimilable fashion both themethod of procedure and the necessary rhythm to be continuouslymaintained.

What is claimed is:

1. Rhythm maintaining apparatus for prone methods of resuscitation,comprising a motor, respiration rhythm indicating means driven atconstant uniform speed by saidmotor and means for arbitrarily settingthe rhythm of such indicating means for either adult or infant rates ofrespiration, said indicating means including the figure of an operatorin the position for prone method of resuscitation and movable insimulation of the correct movements for the prone method ofresuscitation.

2. Rhythm maintaining and instructing meansfor prone methods ofresuscitation, comprising a movable figure occupying the position andsimulating the movements of a prone method operator and motor mechan smconnected to drive said figure at a continuously uniform movementrhythmically representing the proper movements to be followed by theoperator.

3. Rhythm maintaining and instructing meansfor prone methods ofresuscitation, comprising a movable figure occupying the pos1t1on andsimulating the movements of a prone method operator, motor mechanismconnected to drive said figure at a continuously uniform movementrhythmically representing the proper movements to be followed by theoperator and including means for arbitrarily setting the movements ofthe figure for the proper respiration rates for either adults orinfants.

4. Apparatus for making certain proper application of the prone pressuremethod of resuscitation, Comprising a motor capable of running uniformlyand continuously as long as approximately four hours, an indicator formaking known to the operator the timing of the prone pressure movements,gearing from the motor for driving said indicator either at the rate offifteen strokes per minute or at the rate of thirty strokes per minuteand a quick change-over control for said gearing for immediately settingthe indicator either for respiration movements of fifteen strokes perminute for an adult patient or for the rateof thirty strokes per minutefor a child patient.

5. Apparatus for making certain proper practise of the prone pressuremethod of resuscitation, comprising a manikin posed in the properposition for prone pressure resuscitation and having arm and bodyportions movable in simulation of an operator practising the pronepressure method of resuscitation and a motor connected to drive saidnanikin uniformly at a speed corresponding to the rhythm necessary forsuch mode of resuscitation.

6. Apparatus for making certain proper practise of the prone pressuremethod of re suscitation, comprising a manikin posed in the properposition for prone pressure resuscitation and having arm and bodyportions movable in simulation of an operator practising the pronepressure method of resuscitation, a motor, gearing from said motor fordriving said manikin at either the speed for adult resuscitation or thespeed for child resuscitation and means for immediately setting saidgearing for either timing of the manikin and including a plainly visibleindicator to show at once the necessary position of the control foreither class of resuscitation.

7 Prone pressure resuscitation apparatus, comprising a kneeling figurehinged at the knee and having a pivoted arm, means for rocking saidfigure to simulate the body bending, hand and arm movements of a pronepressure operator and a motor for driving said means at continuousuniform speed throughout the protracted periods of resuscitation.

8. Prone pressure resuscitation apparatus, comprising a kneeling figurehinged at the knee and having a pivoted arm, means for rocking saidfigure to simulate the body bending, hand and arm movements of a pronepressure operator, a motor for driving said means at continuous uniformspeed throughout the protracted periods of resuscitation and controlmeans combined with said motor to effect an immediate change-over from arhythmic speed for adult resuscitation to a rhythmic speed for childresuscitation.

9. Apparatus for making certain proper application of the prone pressuremethod of resuscitation, comprising a motor capable of runninguniformly, an indicator for making known to an operator the timing ofthe prone pressure movements, gearing from the motor for driving saidindicator at the rates of approximately fifteen and thirty strokes perminute, for adult and child patients, a quick change-over control foreffecting the setting of said indicator for operation for saidrespiration movements of substantially fifteen or thirty strokes perminute, and indicating means in conjunction with said control to show toan operator the proper position of said control for either class ofresuscitation.

In testimony whereof I aiiix my signature.

FRED KNAPKE.

